Methodist Journal

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ISSUE INTRO

The Scourge of Cardiogenic Shock

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RECOGNITIONS

Arvind Bhimaraj, MD, MPH, Guides Issue on Cardiogenic Shock

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REVIEW ARTICLES See More

Cardiovascular Implications of COVID-19 Infections

Pathophysiology and Advanced Hemodynamic Assessment of Cardiogenic Shock

Cardiogenic Shock in the Setting of Acute Myocardial Infarction

Cardiogenic Shock in Patients with Advanced Chronic Heart Failure

Acute Mechanical Circulatory Support for Cardiogenic Shock

Management of Cardiogenic Shock in a Cardiac Intensive Care Unit

Physiological Concepts of Cardiogenic Shock Using Pressure-Volume Loop Simulations: A Case-Based Review

Systems of Care in Cardiogenic Shock

CASE REPORTS See More

COVID-19: A Potential Risk Factor for Acute Pulmonary Embolism

Repair of Extent III Thoracoabdominal Aneurysm in the Presence of Aortoiliac Occlusion

Williams-Beuren Syndrome: The Role of Cardiac CT in Diagnosis

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

A T2-Weighty Discovery: Aortitis on Cardiac MRI with Histopathologic Correlation

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Acute Kidney Injury in Cardiogenic Shock

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 13, Issue 4 (2017)

Article Full Text

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER

Incidental Finding of a Cardiac Mass on Abdominal CT Scan

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Article Citation:

Ahmad J, Alshammari BS, Nabi F. Incidental Finding of a Cardiac Mass on Abdominal CT Scan. Methodist DeBakey Cardiovasc J. 2017;13(4):253.

doi: 10.14797/mdcj-13-4-253

Keywords
cardiac fibroma , cardiac tumor , cardiac magnetic resonance imaging , CMR

A 21-year-old woman presented to our hospital with symptoms of nausea, vomiting, abdominal pain, and fever. She underwent abdominal computed tomography (CT) to evaluate the abdominal pain, and a mass was discovered incidentally at the left ventricular cardiac apex. She denied any cardiac symptoms.

Further evaluation through cardiac magnetic resonance imaging (CMR) showed a large, well-encapsulated intramuscular mass in the left ventricle apex measuring up to 2 cm 3 cm (Figures A, B). Tissue characterization revealed that the mass was isointense to myocardium on T1-weighted images (Figure C) and hypointense on T2-weighted images (Figure D). On late gadolinium-enhanced (LGE) images, there was marked hyperenhancement, which was characteristic of a cardiac fibroma (Figures E, F).

Cardiac fibromas are benign primary tumors composed of fibroblasts and a large amount of collagen. These uncommon tumors are primarily found in the pediatric population, and their prevalence among adults is rare.1,2 Mainly located in the ventricular septum or left ventricular wall (intramural),3 these tumors have much extracellular space for gadolinium accumulation, resulting in intense enhancement on CMR LGE images. A cardiac fibroma may lead to congestive heart failure or invade conduction tissue and cause ventricular arrhythmias.4 Surgical resection is indicated in symptomatic patients.

Our patient remains asymptomatic and is monitored closely for symptoms. Repeat CMR imaging at 6 months demonstrated no change of the mass, suggesting that the lesion is benign.

References

1. Stéphant E, Ana S, Philippe D. Inter-ventricular septal cardiac fibroma in an adult: MR and MDCT features with pathologic correlation. Eur J Radiol Extra. 2008 Sep;67(3):e103-6.

2. Yu K, Liu Y, Wang H, Hu S, Long C. Epidemiological and pathological characteristics of cardiac tumors: a clinical study of 242 cases. Interact Cardiovasc Thorac Surg. 2007 Oct;6(5):636-9.

3. Padalino MA, Basso C, Milanesi O, et al. Surgically treated primary cardiac tumors in early infancy and childhood. J Thorac Cardiovasc Surg. 2005 Jun;129(6):1358-63.

4. Becker AE. Primary heart tumors in the pediatric age group: a review of salient pathologic features relevant for clinicians. Pediatr Cardiol. 2000 Jul-Aug;21(4):317-23.

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